The authors wanted to systematically review evidence on the effect of health information technology on quality, efficiency, and costs of health care. Two reviewers independently extracted information on system capabilities, design, effects on quality, system acquisition, implementation context, and costs. Out of the 257 studies that met the inclusion criteria, most studies addressed decision support systems or electronic health records. Approximately 25% of the studies were from four academic institutions that implemented internally developed systems; only nine studies evaluated multifunctional, commercially developed systems. Three major benefits on quality were demonstrated: increased adherence to guideline-based care, enhanced surveillance and monitoring, and decreased medication errors. The primary domain of improvement was preventive health. The major efficiency benefit shown was decreased utilization of care. In conclusion, four benchmark institutions have demonstrated the efficacy of health information technologies in improving quality and efficiency. Whether and how other institutions can achieve similar benefits, and at what costs, are unclear.
Annals of Internal Medicine.
742-752 Epub 2006 Apr 11
Systematic Review, Return on Investment